| NPI | 1194439133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYNE A BOUGUYON Owner 214-476-1719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 174H00000X Health Educator |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 225700000X Massage Therapist | |
| 225800000X Recreation Therapist | |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2023-01-12 |